Dual use of electronic cigarettes and tobacco in New Zealand from a nationally representative sample

Aust N Z J Public Health. 2019 Apr;43(2):103-107. doi: 10.1111/1753-6405.12871. Epub 2019 Feb 6.


Objective: There is strong interest in the use of electronic cigarettes (e-cigarettes) globally. Not much is known about the dual use of e-cigarettes and combustible tobacco cigarettes, or if there are demographic differences among dual users and e-cigarette only users. This paper reports on the demographics of dual users and e-cigarette only users in New Zealand in a nationally representative sample.

Methods: The Health and Lifestyles Survey (HLS) is a biennial face-to-face in-house survey of New Zealand adults aged 15 years or over. The HLS was completed by 3,854 participants in 2016.

Results: There is clear evidence of significant dual use in the current sample: most current e-cigarette users (63.9%) were dual users. Respondents 45 years and older were twice as likely to be dual users as those aged 15 to 34 years.

Conclusion: The current study found evidence for substantial dual use of e-cigarettes and combustible tobacco cigarettes among adult e-cigarette users, particularly among users aged 45 years and over. Implications for public health: Public health initiatives should provide clear advice that e-cigarettes should be used as a smoking cessation tool and not as a way to allow the consumption of combustible tobacco to continue.

Keywords: dual use; e-cigarettes; prevalence; tobacco; vaping.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Electronic Nicotine Delivery Systems*
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • New Zealand / epidemiology
  • Nicotine / administration & dosage
  • Prevalence
  • Socioeconomic Factors
  • Tobacco Smoking / ethnology*
  • Vaping / ethnology*
  • Young Adult


  • Nicotine